Eliska O
Anatomický ustav 1, LF UK, Praha.
Cas Lek Cesk. 2006;145(4):329-35.
It has been 160 years now since Purkynje published the finding of conduction fibers in the heart in Archiv f. Anatomie u. Physiologie and it has been 166 years since his publication in polish version. Already during Purkynje's life, some anatomists had solved the morphology of these fibers but nobody at that time knew of what great physiological and medical importance this discovery would be for medicine. It was seen as late as in the 20th century and in contemporary times. Purkynje's work indicated the cascade of these discoveries, which were leading in the beginning of the previous century to the formulation of the basic scheme of the conduction system. Purkynje fibers or Purkynje cardiomyocytes are part of the whole complex of the cardiac conduction system which today is classified as specific heart muscle tissue, being responsible for the generation of the heart impulses. From the point of view of ultrastructural composition, the cells of different parts of the cardiac conduction system are partly similar. In contrast to the heart contractile cardiomyocytes, the cells of the cardiac conduction system including Purkynje fibers have a small amount of myofibrils,small mitochondrias, light cytoplasm and a higher glycogen content, but no T-tubular system. They can be detected with some morphological methods. Nevertheless the cells of the conduction system are not completely uniform. They differ in size, number of nexuses-gaps and intercalar discs in individual parts of the conduction system. Nevertheless, these specialized cells work as a whole-unit. Nowadays, the morphology research of all the parts of cardiac conduction system, including Purkynje fibers, is focused on ultrastructural, histochemical and genetical problems. The question is, wheather with future gene/cell therapy disturbances of the conduction system such as arrythmias, can be prevented and cured by replacing the electrical pacemakers with biological ones. If Jan Evangelista Purkynje lived today, he would be surprised but surely delighted with the high degree of research concerning his discovery and its clinical application.
自浦肯野在《解剖学与生理学文献》上发表关于心脏传导纤维的发现至今已有160年，而其波兰语版本的发表距今已有166年。在浦肯野在世时，一些解剖学家已经解决了这些纤维的形态问题，但当时没有人知道这一发现对医学具有多么重大的生理和医学意义。直到20世纪及当代才认识到这一点。浦肯野的工作揭示了这些发现的脉络，这些发现在上世纪初促成了传导系统基本方案的形成。浦肯野纤维或浦肯野心肌细胞是心脏传导系统整体复合体的一部分，如今被归类为特殊心肌组织，负责产生心脏冲动。从超微结构组成来看，心脏传导系统不同部位的细胞部分相似。与心脏收缩性心肌细胞不同，包括浦肯野纤维在内的心脏传导系统细胞肌原纤维较少、线粒体较小、细胞质淡且糖原含量较高，但没有T小管系统。可以用一些形态学方法检测到它们。然而，传导系统的细胞并非完全一致。它们在传导系统各个部位的大小、连接间隙数量和闰盘数量上存在差异。尽管如此，这些特化细胞作为一个整体发挥作用。如今，包括浦肯野纤维在内的心脏传导系统所有部位的形态学研究都集中在超微结构、组织化学和遗传学问题上。问题是，未来通过基因/细胞疗法，用生物起搏器替代电起搏器，是否能够预防和治愈诸如心律失常等传导系统紊乱。如果扬·伊万热利斯塔·浦肯野生活在今天，他会对关于他的发现及其临床应用的高度研究感到惊讶，但肯定会很高兴。
